Quick Weight Loss

May 13, 2003 — Surgeon experience, and sleep apnea and hypertension in patients are associated with complications after laparoscopic Roux-en-Y gastric bypass (RYGB) surgery, a procedure to aid in weight loss by surgically attaching a loop of the small intestine to the stomach, allowing food to bypass the stomach and part of the intestinal tract, according to an article in the May issue of The Archives of Surgery, one of the JAMA/Archives journals. Obesity is a major health problem in the United States, and is estimated to account for approximately 280,000 deaths per year, according to information in the article. Obesity is associated with many other health risks, including hypertension and type 2 diabetes mellitus. RYGB surgery is one of the most commonly offered surgical procedures for the treatment of obesity and appears to offer the best long-term results. Richard A. Perugini, M.D., of the University of Massachusetts Medical School, Worcester, Mass., and colleagues obtained data on at 188 patients with severe obesity who met the National Institutes of Health guidelines for undergoing RYGB surgery. The researchers recorded all complications that required intervention, and the amount of weight lost in the year following surgery. The researchers found that of the 188 patients, 50 (26.6 percent) developed complications that required an invasive therapeutic intervention, including two deaths. The researchers identified surgeon experience, sleep apnea, and hypertension as predictors of complications. The most common complication requiring intervention was stricture of the gastrojejunal anastomosis (narrowing at the site where the loop if small intestine is attached to the stomach) occurring in 27 patients (14.4 percent). Weight loss data were available for 93 patients (81 percent). The BMI of these patients dropped from an average of 53 before surgery to 35 at one year after surgery. The average percentage of excess body weight lost after one year was 61 percent. The researchers also found that diabetes mellitus was negatively correlated with percentage of excess body weight lost after one year. “This series corroborates several others in demonstrating that a laparoscopic approach to RYGB is feasible, even in superobese patients,” write the authors. “Furthermore, results with regard to weight loss appear to be similar to those reported in open literature. Laparoscopic gastric bypass should be accepted as at least the equivalent of open gastric bypass as a bariatric procedure